My D&C, Or: I Know It Was Supposed To Be Terrible, But It Wasn’t & Here’s Why, Or: On Barbecue & Babies, Manicures & Miscarriage

I like painting my nails. It’s sort of how I like cleaning the bathroom, a small room that can be done in an hour.  I can’t handle the commitment to a daily makeup or hair routine, my clothes are a mess, but I can find a color that makes me happy, and throw it on my nails with skill, and look down at something that pleases me, every once in a while. I write with those hands, too, which isn’t lost on me.

 

That day, my nails were pretty delightful. I’d tried out these crazy stick-on things that week, white polish with black script, as though I’d really taken the writing metaphor all the way. We woke up and went to the place we were supposed to, gripping each other. I went to sign in, and the person at the desk looked at me, and my hands, and said kindly, “Oh, my! Those are beautiful! Can I see?” She took my hand. I wanted to stay there, to say thank you for holding my hand, I know you know what I’m here for, that I thought I was nearly about to break except they told me I was already broken, and here you are holding my hand, sharing this interest that holds no weight, no special tie to the fetus that is still inside me, but holding my hand anyway.

 

I sat back down.

 

I read an email from a colleague. We had a work trip planned, something new and exciting, a project that showcased my skills and took me to a place I’d never been. Colleague was keen to get a move on planning it. Colleague had heard the bad news, said the email, but colleague didn’t want to talk about it, colleague said. Oh. Okay. Well, anything for you, colleague.

 

Text from another colleague. They knew I’d told them before, but could I remind them of the password? It’s “buzz off”, I wanted to write. Don’t you know where I am? I texted back the password, plus some pre-emptive answers to questions I knew would come up in my absence. “Just FYI, I’m going offline,” I wrote. ‘Gotta dilate this cervix and remove the fetal tissue now, deliverables, etc,’ I didn’t write.

 

We went back to an exam room. There was an ultrasound machine, on, but with no picture, just a grayscale blank the shape a windshield wiper clears in the snow. This was the same sort of screen on which we had seen the heartbeat weeks ago. This was the same sort of picture we had sent to friends and family. This is the same sort of screen we had been peering at when a technician I’d never met said, “No. No baby! No heartbeat. Growth stopped. No baby. Sorry.” Sorry. No baby, no parents. Go back to your day job.

 

I lost it. I hated that screen. I wanted to smash it to bits, to ban it from all medical facilities everywhere. “It’s okay,” the doctor said. “You can do whatever you need to.” He had curly hair, and his scrubs were a green blue that the internet tells me is something called “terrace garden” or “forest canopy”, printed with the name of the hospital, ad infinitum. He was a resident, I learned, and he was so good at his job.

 

What followed was what I think every doctor, every patient wants but almost never has. It was just time, time spent talking, time spent quiet. Time filled with logistical questions, and unanswerable questions, and resolutions that the doctor didn’t need to know but I told him. “We thought we were parents,” I said. “You still are, you still can be,” he said. “This is hard,” he said. “Impossible.”

 

He laid out my options, with no judgement. You can go home, he said. Right now, he said, if you want to. You can wait, or we can give you a medicine to help the process along. It’s hard, he said. But you might want it, he said. You’ll need to come in for another ultrasound to be sure there is no remaining tissue, and it can be quick and painless, or take a long time and have lots of cramping.  But it’s about what you need emotionally. We’re here for you.

 

And they were.

 

The other option was what I came for. General anesthesia. Dilating my cervix. Removing the fetus. Curettage or vacuum aspiration to remove the remaining tissue. And then I would wake up, and no longer be pregnant.  And then I could mourn my loss, because I would have lost it, and it would be done. It would be done.

 

I was thankful for modern medicine. I’ve suffered trauma, and that makes me sort of afraid of the range of emotions I know I’m capable of. Structure is good where grief is concerned. Let’s not do this in my bathroom at home, the one where I saw the positive test, the one where I soaked in a bath, the temperature of which I’d measured so as not to harm the growing fetus.

 

I still felt pregnant. I was still vomiting every day. I’d been on my honeymoon with a dead baby in me, taking pictures of my still growing belly, calling the little bundle a strawberry. We canceled all of the cider tasting, pub visiting, horseback riding across Somerset when we found out. There was joy in being pregnant, so I didn’t regret it. But–well, it was what it was.

 

I’d lit a candle in the Wells Cathedral. I wonder what that candle ended up being for, after all. I took a picture of it, the singular flame. I don’t believe in a tit-for-tat kind of God, the kind who agrees that I know best and gives me just what I ask for, even if I rarely ask. I didn’t think that candle provided special womb protection, traveled back to the moment of conception and assured against any chromosomal abnormalities that would lead me to miscarry. But when I lit it, I did think it carried the light of my new role, the light I felt glowing around me each time I remembered I was pregnant.

 

The D&C, the removal of the tissue, the procedure, the anesthesia, etc, was decided. The doctor left me, and a nurse came in. She read the room, and declared that she had to see my nails. “The whole office is talking about them,” she said. Never had a girl felt more impressive with a drugstore accessory than I did that day. And never had I experienced such an unobtrusive way of coaxing me into being cared for, doted upon, for having an excuse to hold hands when I would have never asked.

 

We moved from the room of the barren-ultrasound-machine to one of a series of curtained off sections in a large open area, like an ER of sorts. Conversations buzzed around us, welcome distractions and reminders that we weren’t alone. It felt strangely comforting to hear snippets of the experiences of others, people we couldn’t see and wouldn’t see again. “You can take ibuprofen for the pain, or call us if it’s not enough.” “You’ll see bleeding for a few days.”  “When can we try again?” “You might feel some cramping.” “Could you tell what it was?”

 

The anesthesiologist came to see us. I was most worried about the anesthesia, as I’d never gone under before. It seemed like diving off the edge of a great precipice, being robbed of all sensory input, of all cognitive awareness, of the ability to feel and think. It seemed frightening– and completely glorious. To learn of none of it.

 

The pace picked up, and soon I was being wheeled into another room. There was a chair with stirrups, lots of lights, instruments, some sort of mask for me to inhale things through. It hit me that I was having surgery, that I was in an operating room, that I was surrounded by surgeons and they were preparing to operate on me. And I was terrified.

 

Everyone spoke in calm, soothing voices to me, and in the most professional, no-nonsense tones to one another. I choked out to a nurse, across the room, “Please help. I am scared shitless.” It wasn’t my most eloquent. It was how I felt. Again, the hand. She grabbed my hand and started rubbing it furiously.

 

“I like to talk about food,” she said. “You must be starving! And after all this, you can eat whatever you want. What are you going to eat first?”

 

I hadn’t eaten for something like 16 hours. Food sounded fabulous. I had a craving deep down for something heavy and comforting, rich and overwhelming. I wanted barbecue so bad.

 

“Barbecue. All I want is barbecue. And I have no idea where to get it! I don’t even know of any good barbecue spots in the city!” I wanted the kind of weird but glorious barbecue you can find in crock pots and chafing dishes in gas stations in the south– or maybe cheap and delicious Tex-Mex, a banh mi from that building shaped like a milk bottle and an Indian taco served at a fundraiser, fourteen thin paper plates supporting its weight. I wanted food from home.

 

The resident perked up. “BARBECUE! YES! How about Fette Sau? It’s insane.” The room buzzed. “Ooooh, where is that?”

 

“Is that French?” The awkward anesthesiologist chimed in.

 

“It’s barbecue. It’s fucking delicious,” replied the resident.

 

The oxygen mask went on my face. A kind doctor stood over me. I remembered her from my initial google searches for gynecologists upon my move to this new, foreign city. “I know you,” I said. “You have an MPH.”  It was important to me, a focus on public health. It didn’t really matter right now.

 

She smiled. “I do!” Things sped up, slowed down, at once.

 

“Okay!” chirped the anesthesiologist, done futzing with whatever it was he was doing with the drugs I would soon be breathing in. He seemed less than impressed with barbecue. That’s okay, he wasn’t invited anyway.

 

Everything shifted, monumentally. “Whoa,” I muttered. “I feel craaaaaaaaaaaazy.” I was flying, or swimming, or something. Maybe I was falling into my own womb.

 

“Go with it,” said the resident, and I could have sworn we held eye contact as I floated away.

 

I awoke 15 seconds, an hour, or a couple of years later. Mike was there. I immediately tried to sit up, to shake the sleep off, to acknowledge that I was still alive. I mean, I think they knew, but I wasn’t sure.

 

Dr. Public Health had gone to let Mike know everything had gone okay. She told him I needed barbecue and they recommended Fette Sau.

 

The nurse who brought him back to me in the recovery area had also reminded him that I was hungry, and he should take me out for barbecue. The place was in Williamsburg, she said, and the other doctor would know the name.

 

They came to give me the summary: all went well, and they were able to remove all of the tissue. I was grateful. I had been sitting in grey-blue light of spring, alone, for far too many hours with death inside of me. Even though a part of me had died, was wounded, needed to grieve, I was glad to be rid of that talisman. Ready to create some space for Mike and I to cry and cling; and then, eventually, to move forward.

 

And barbecue. Two more people stopped by to remind us. They told us to order the burnt ends. The resident stopped by again, and noted my MPH comment. Oh. So it had happened. I really had outed my encyclopedic memory of the credentials of every person I’ve ever googled. “I’m glad it’s important to you. It’s important to us. It’s intrinsic in what we do,” he said. “We care. We care a lot.”

 

I got dressed, took home discharge instructions on a brightly colored flyer. Mike and I ordered take-out Indian food and ate it on the couch that night. I wasn’t in any shape to go out for barbecue, but deeply appreciated the theatrics and continuity of care regarding my next meal, even if we all had an inkling that it was a ruse.

 

We went camping the next day. I didn’t want to be in our home. It was quiet, and some deer took a walk with us. We rowed a boat on a lake, meandered, and I drank a beer, because I could now. I cried because I could. It felt awful. It tasted fine.

 

It took us just a few months before I was pregnant again, pregnant with the nearly three-year-old girl now following her daddy around the house, telling him stories a mile long. My due date with her  (and many subsequent days) came and went, and so I showed up at the hospital for an induction in the same way a kid shows up to school on field trip day. The high-risk OB I’d seen a few times during the pregnancy stopped by to wish me luck. “Trust your pelvis,” she advised.

 

I walked back to the labor ward, where I would, in a few hours, deliver Winnie into an overly warm and terrifically welcoming room. Among the doctors and nurses , I caught a glimpse of the curly-haired resident, furiously entering notes on a computer. I didn’t need to go back to that place, didn’t need some great catharsis. But I noted to my OB when she checked in between contractions later that he and the rest of their staff had made what should have been one of the worst experiences of my life into one of the most healing, and I was glad to see his face. And maybe I’d get that barbecue, one of these days. It came highly recommended, after all.

 

How I Cope

It’s no secret to anyone who has known me for any amount of time (or sometimes even to the nice mom I meet in the coffee shop, within about five minutes of chatting–sorry, nice person!) that I have struggled with depression and anxiety for most of my life. Like many chronic illnesses, it ebbs and flows, and I’ve had varying degrees of success in treating it over the last sixteen years. Indeed, it was half a lifetime ago that I booked my first appointment with a mental health professional, and I can’t help but feel some sense of strength and accomplishment from this journey, from what I have learned, and from the nitty-gritty work I’ve put in.

The years have been full of trial and error, and when I first became pregnant in the spring of 2012, it felt as though the rules of the game had changed.  Now, my body (and accompanying hormones) were rapidly changing; now, I had to consider the growing bundle inside of me; now, I scared my psychiatrist, whose experience in treating pregnant women was lacking. Within that time, I lost the pregnancy, which brought a new set of challenges, of grief and hope, for both Michael and me.

All of the bits and bobs of this story, of the journey up and over, around and through the darkness and light warrant another post, or two or three. But through three pregnancies, two births, and many, many, many-many cups of coffee and tea with my fellow mothers-in-arms, I’ve learned a few things. Right now, I am at the point postpartum with Georgie where, with Winnie, I recognized that things had become very dark, and thus I am hyper aware of the challenges I face right now and how I can work through them. I write this in the hope that perhaps my footsteps can serve to help another mother who struggles with a Perinatal Mood and Anxiety Disorder— but also as a roadmap, a reminder, for myself as I work through the next months and years.

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Mindfulness Practice

Far and away the lowest barrier to entry, most effective, “bang-for-my-buck” if you will, tool in my recovery toolkit has been mindfulness practice, both through dedicated mindfulness meditations and the continuation of those practices throughout my day. Guys, I am not a meditator. Before I started mindfulness meditation, I could barely close my eyes if not asleep nor could I concentrate on breathing if not, you know, gasping for air or something. The suggestion of “deep breaths” was enough for me to never return to see a therapist or psychiatrist. Part of this was, of course, that I struggled with post-traumatic stress disorder as a result of childhood trauma– closing my eyes and opening my mind to the possibility of re-experiencing the trauma was terrifying. I half-heartedly read The Healing Power of the Breath, which was developed with trauma survivors in mind, and much to my surprise, I found the tangible focus to be helpful; in fact, I used its techniques during Winnie’s birth. Also while preparing for Winnie’s birth, I stumbled on Mindful Birthing, which utilizes mindfulness techniques to help women work through the sensations of pregnancy and childbirth, as well as the postpartum period.

After postpartum depression and anxiety reared all manner of ugly heads when Winnie was around seven months old, I established an exceptionally trusting relationship with a healthcare provider (more on that later) and when she suggested mindfulness practice, I took her up on it and checked out Mindfulness for Beginners from the public library. I uploaded a few meditations onto my phone and began to practice daily. Holy crap, you guys– it worked! Unsurprisingly, I suppose, when you practice something, you get better at it. The dedicated daily time to practice breathing, to practice allowing thoughts to exist without judgement, to practice moving between difficult thoughts and comforting sensations in a safe space reduced the fear I had of my emotions and my ability to co-exist with them. It particularly helped with the heightened emotions I had as a result of hormonal changes during my pregnancy with Georgie, and with the intrusive thoughts that followed a few weeks after her birth. With Winnie, I spent nights awake in a panic, in fear and disgust at such thoughts– how could a good mother think such things? Where were these thoughts coming from? Did intrusive thoughts mean that I would act on them? No, it absolutely didn’t– but my fixation on the thoughts, my judgement of them and my fear of them exacerbated them. Mindfulness practice taught me to allow the thoughts to pass without judgement, and because of this, they resolved quickly, without the panic and terror they had previously caused.

Now, I practice mindfulness daily: I set a meditation goal using the Strides app (my other Strides goal is flossing, in case you were wondering) and use either the Mindfulness Coach app (developed by the US Department of Veterans Affairs for veterans suffering from PTSD, but helpful for anyone) or the free guided meditations from the Mindfulness Awareness Research Center at UCLA (the Working through Difficulty and Loving-Kindness meditations are my favorite). To me, mindfulness practice is, at its core, a way to practice being the person you want to be, with the brain you want to have.

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Finding My Team

Real talk: finding a mental health team is a pain in the ass. No, it’s worse. It’s nearly criminal. It’s expensive, time consuming, requires a ridiculous level of information literacy and perseverance, all of which is completely overwhelming to someone suffering from a mood or anxiety disorder. When you think you’re worthless, when you think you’re helpless and hopeless, how are you supposed to justify the hours of google searches, phone calls to doctors, messages left, phone menus navigated, “not taking new patients”, “out of network”, ad nauseum? If you’re a danger to yourself or others, go to the ER, otherwise you’ll need to wait months and months in your own emotional hell to see if this provider might– just MIGHT– be a fit for you. It is a dance I have done, and one I wish to avoid for the rest of my life.

Luckily, there are some resources. First, from my own experience: Postpartum Support International. PSI offers a warm-line, online support meetings, free weekly phone support meetings with a postpartum expert, a Facebook group, and– my personal favorite– a resources map with area coordinators. Before we moved to New Mexico, I contacted the PSI coordinator for the area, and she provided me with a list of resources, tracked down doctors, support groups, and therapists. She even called doctors’ offices to see if they had experience treating PMAD. So much footwork done, so many obstacles removed. (PS: PSI has resources for dads, too.)  I haven’t personally used their services, but many recommend Postpartum Progress, as well.

I also can’t stress enough how important a trusting relationship with a mental health provider is, once you’ve jumped through those hoops. I was lucky to find an incredible psychiatrist with training in reproductive psychiatry, who took an integrative approach to my care: she ran blood work to test for nutritional markers and any other physical problem that could interfere with my recovery, she recommended mindfulness practice and respected my desire not to delve into trauma work, instead recommending structured Dialectical Behavioral work. She helped me balance breastfeeding, pregnancy, and medication, giving me the vocabulary I needed to approach the issues with my birthing team. I had never before put in the work that I did with Dr. Hermann, and it was the trust we built that led me to do so.

I was, admittedly, nervous when I moved and changed doctors. Memories lingered of a bad experience following my first pregnancy loss and subsequent pregnancy with Winnie. The psychiatrist I had seen then was less than supportive, reluctant to provide any information about treating depression with medication during pregnancy outside of FDA pregnancy categories, and seemed to think that my decision to get pregnant while still struggling with depression had been a mistake, and that was that. But after the work I put in treating my PPD/PPA after Winnie,  I felt armed with the knowledge that the medications I was taking were safe, that any risks were outweighed by the benefit of having a whole, present mother, and that I deserved answers to questions and treatment as a human.  And lo! The psychiatrist I saw here in New Mexico totally agreed! We discussed each medicine, each supplement, and concrete exercises to overcome a recent flare-up of traumatic experiences, recurring nightmares. We both talked about how if a doctor/patient relationship doesn’t work, you can and should find someone else, but at the end of my appointment, when I expressed relief and my previous apprehension, she smiled sincerely and said, “Don’t worry– I’ll take good care of you.” Isn’t that just what every patient wants to know?

So, I don’t do therapy, and I won’t until I’m in a place to pursue trauma work, but I know it’s so important for people. My other “team” tool, in addition to a capable mental healthcare provider (be it psychiatrist or therapist), is pretty simple: other moms.

For me this meant  a local moms group (shoutout to my Summer13 Cortelyoumoms! woo woo, party people!), full of women who had and hadn’t experienced depression and/or anxiety, full of women who were approaching the same challenges every day, full of women who could go for a walk, or make a joke about diaper on Facebook. Parents’ groups are an invaluable resource– I’m not a joiner, and I was afraid that either I would hate everyone in the group, or everyone in the group would hate me, but it turns out that people are people, and being able to talk about Dinosaur Jr while wrangling a toddler or about Judith Butler while nursing is pretty rad, and definitely helps mental health!

Finding my mom team also meant attending a support group after Georgie’s birth to process my experiences and learn new tools. Hearing the varied experiences of other women, empathizing, and in some cases, even being able to offer my own experience as valuable, as a tool for others, was incredibly empowering. Brooklyn moms, I highly recommend Sarah Moore’s PMAD group as a part of your toolkit.

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Self Care

Okay, here’s the fluffy but oh-so-important stuff:

  • Taking a shower.
  • Brushing my teeth, not once but twice (!) a day.
  • Eating good fats and proteins.
  • Having a hot (or warmish) cup of coffee in the morning.
  • Getting sun on my face.
  • Putting on real pants. If I’m feeling extra in-need, real pants THAT FIT.
  • Listening to WQXR.
  • Calling a friend.
  • Wearing wool socks.
  • Spraying this stuff on my face.
  • Checking out a library book, because it feels kind of like guilt-free shopping
  • Taking my prescribed medicines at the same time, every day
  • Taking the vitamins I need, like B-Complex, postnatal, and vitamin D
  • Turmeric supplements for depression, because it might help, and my doc says it can’t hurt

This list changes, but there is *always* a list, and there must be. I need to start each day with a bank of things that can lift me up if I start to fall. When I was in crisis mode following Georgie’s birth, after Mike had gone back to work, family was all gone, and I was alone with two lovely creatures who desperately needed me and also sometimes hurt me (I struggled mightily with the physicality of parenting) and a rollercoaster of postpartum hormones, I sometimes felt like the sky was (metaphorically) falling. And during those times, I put Georgie in the carrier, Winnie in the stroller, filled up a mason jar with coffee, and walked and walked and walked and walked. Miles. All throughout Prospect Park, where I could find a grassy spot, near people but not too near them, let Winnie sleep in the stroller and Georgie in the carrier, in such a way that they were cared for but I didn’t have to actively engage, and I would just CRY. Quietly, but fully. We were all safe. We were all loved. I’d certainly rather have filled my days with less crying, less emotional turbulence, but there it was. We did it.

We’re doing it. Every day, getting by.

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Georgie, A Birth Story: Active Labor and Gettin’ Born’d

We live ten miles from the hospital, which in New York driving speak means anywhere from 20 minutes to an hour and change to get to the hospital. I cranked up the Bach on WQXR and moaned my lowest, calmest om-iest moans. I rolled down the window and let the rain and wind hit me in the face (highly recommended). I did not keep it together for the sake of the toll-taker. Sorry, dude– just bring life into the world and all.

By the time we got to the hospital, my contractions were two minutes apart, lasting about a minute. In case I’d been too charmed by the it-takes-a-village spirit of my local library, the universe sent a dozen DGAF construction workers to exit the hospital using all nearby doors while I was trying to waddle-run inside. New York, New York!

We hustled past the fancy water features in the hospital lobby, past folks in scrubs and white coats and suits and the like (I had changed into clean leggings on our way out– I’m not a monster!) to the elevator bank. I managed to not have a contraction in a packed elevator, which was pretty terrific. Just two more contractions, and I was in my labor and delivery room.

Here’s where my ambivalence comes back into play. After I was settled, my contractions slowed a bit, but continued at a pretty steady clip every 2-3 minutes. I was four centimeters dilated, but Georgie was still quite high in my pelvis. My doctor asked if I’d planned on getting an epidural, and my answer was a completely honest, “I don’t know.” I knew I could do it without an epidural, I just didn’t know if I wanted to. I was feeling pretty in control of my ability to manage my pain and energy, but I didn’t want to take pain relief off the table.

And then there’s this, which I hadn’t fully processed before this birth: as a kid, I suffered some pretty serious physical abuse. It impacts the way I deal with anxiety and pain– my fight or flight response is more of a FLIGHT! FLIGHT! FLIGHT! response. The flip side of this is that I’ve done a lot of self-work over the last fifteen years, which has given me a whole mess of tools and insight that I might not have had otherwise. That awareness, I think, contributed to my ambivalence– what message would I send to myself with the choices I was making? Was I telling myself that it was okay, that I had nothing to prove, that I was strong and capable either way? Or was I telling myself that I could handle the pain, conquer it and rise above it? I mean… yes?

When Winnie was born my grandmother offered me a wonderful piece of parenting advice, which I think applies beautifully in birth, too: don’t just do something, stand there! And so I stood. We’ll see, I said. We lowered the lights, turned on monastic chants and Hildegard Von Bingen, and started breathing into the zone. I think at some point I threw up.

Given that my contractions were so close together and Georgie’s station was still so high, my doctor suggested breaking my water. Looking back, I wonder if I should have consented so enthusiatically, but at the time I felt present and active in the decision. Plus, I kind of love that weird crochet hook they use to rupture your membranes. It appeals to the craftiness in me.

Rupturing my membranes revealed meconium in my amniotic fluid, which could have been indicative of fetal distress, or, more likely, just an innocuous indicator of the fact that my baby was post-date and, you know, when you gotta go you gotta go, even when you’re a fetus. But I forgot that whole innocuous bit and literally threw myself back into my hospital bed, wailing, “Do whatever you have to do to get her out!” Oh hormones, you so crazy.

Cooler heads prevailed, and my doctor reminded me that meconium wasn’t a problem on its own, that all could continue on its own time, though they did want to continue to monitor the baby’s heart rate and my contractions, so no roaming the halls for me. My contractions intensified, and Mike helped me to dig deeper through the breath and guided body scans. I stayed on top of the pain, but the contractions felt as though they were right on top of each other, a feeling confirmed when my doctor and a handful of others swiftly entered the room. It turned out my contractions were more than close; I was experiencing something called uterine tachysystole. On went the oxygen mask and I changed positions, while my otherwise reserved, keeps-her-distance doctor hopped on the bed with me and softened her voice. Everyone stayed really calm, but the pain and stress of what felt like one never-ending contraction were getting to me.

Earlier in the day, my doctor and nurses had been pep-talking me through the possibility of a medication-free birth: you can do it, they said, and I could! We had chosen our practice and hospital because they were supportive of unmedicated, low-intervention childbirth. So I had a good feeling that when my doctor suggested that we go ahead with the epidural to slow things down a bit and give me a chance to breathe, she wasn’t doing it because she was getting paid the big bucks by Big Pharma or had a tee time to make or was just really sick of hearing my version of Moanin’ with the Motets. I threw her a big thumbs up and called a time out.

The anesthesiology resident was soon in the room. Mike hadn’t been able to stay in the room for my epidural with Winnie, but this time I got to clutch his arms during the epidural insertion, which was terrifically comforting. I’m not trying to brag or anything, but the doctor said I had the best back positioning he’d ever seen. That’s definitely going on my résumé.

I regaled the kind doctor with tales of my first epidural during Winnie’s birth, which I’d dubbed “perfect”, “magical”, and “a game changer”– just really trying to set that bar way up high. The epidural did not disappoint– I maintained feeling and movement in my legs, I could move around in the bed, and I still had an awareness of the pressure, and eventually the pain, of my contractions. My contractions slowed down enough that everyone could relax, too. I was able to take a deep breath, gather my strength, and turn my attention to the real work of labor: the myriad juices, jellos, broths, teas, ginger ales, and spoonfuls of honey that the nursing staff and Mike had amassed for me. Clear liquids, for the win!

Mike and I spent the next couple of hours talking, reading, and updating family members. Our friends who were watching Winnie sent us adorable pictures of her visiting the coffee shop and sandwich spot in our neighborhood. We reviewed my labor support Google Docs (no joke– I had a whole folder). I instagrammed a few things, because why not?

On the advice of my nurse, I kept as mobile as I could in the bed.  I wanted to feel as much as I could stand so that I could stay connected to the changes my body was going through as my labor progressed, and luckily my epidural was patient controlled analgesia, meaning that I could administer a certain amount of the analgesic via the epidural by pressing a button.  Because I didn’t know when I would be ready to push, I tried to avoid pressing the button too much so that I could stay as present as possible.

My mom’s plane landed, and I told her to swing by the hospital on her way to pick up Winnie. I thought it might be a while, so I asked her to bring Winnie back up to the hospital.  Hey, mom!  I know you landed minutes ago in this crowded, complicated city, but would you mind swinging back by with my toddler? It’s just like, a train to a train, then a train to a bus or a train to another train. Cool, thanks.

I texted a group of friends to ask them to be on call for my mom’s direction questions (hahaha lol) which set off a wave of texts of, “no offense but are you crazy?” and “uh, do you just want us to bring her?” and “please–no–what–we will pick her up!” all of which had the subtext of “did they put that epidural in your brain, lady?”. My phone was buzz-buzz-buzzing while Mike drew my mom a diagram of the various transit options. “HERE!” I shouted, tossing my phone to Mike while I jammed hard on the button that controlled my epidural.  “You two go out in the hall and figure this all out. It can’t possibly be as hard as having a baby, which is what I’m doing right now, and can you PLEASE TURN UP THE TAIZE CHANTS FOR THE LOVE OF GOD?!”

The contractions amped up, and the pressure in my tailbone was growing increasingly painful. My tremendously kind, insightful nurse popped in to tell me she was leaving, and I almost grabbed her arm and begged her not to go.  The world’s most hilarious, gregarious, epically positive nurse had covered for her lunch break, but alas, no such luck now. At around 5:15, a new nurse came in, and started fiddling with the Pitocin drip next to my bed, which I’d been given along with my epidural, set at the lowest dose.

“Oh hi! Whatcha doin’?” I asked.

“Increasing your Pitocin,” she replied.

“Why?” I asked.

“That’s what you do,” she replied. (I am not kidding.)

“Do you have to?” I asked. (‘No,’ I thought.)

“Your doctor ordered it,” she said.

“Oh! Then can I talk to her? I’d really rather you didn’t increase it,” I said. BOOM. STILL GOT IT. I psychically high-fived our doula from Winnie’s birth, Jillian.

My doctor came in, and explained that since I’d been tolerating the Pitocin so far, they could increase it. I said I’d rather we didn’t, as the pain was increasing and also, you know, I don’t have anywhere to be, so let’s just let this whole thing work itself out, yeah? “Can we wait a half an hour?” I asked, at 5:20 p.m. We could, she said.

Things continued on an upswing, and I closed my eyes, centered, and came back to the breath again. Soon enough, things felt different.  Like, different different. I called the nurses’ station. “Hi there, I, uh, I think I have to push? Maybe?”

My doctor came back in the room. It was 5:40.

“You think you have to push?” she asked skeptically.

“Yeah, but I mean, I feel like I could maybe hang on a little longer. It just feels different, you know?” She did not know. I did not know.

She checked my cervix. “You’re fully dilated,” she said– sweet!–“but the baby’s still pretty high.  Do you want to try a test push?” Sure! Why not? I love tests!

Because I had pretty killer symphasis pubis dysfunction (I was advised to not do anything during my pregnancy that involved moving my legs in opposite directions, which is literally everything), my PT had advised a few different positions for pushing. But hey! This was just a test, just for funsies, giggles, kicks. So I just leaned back on my bed a little, and bore down.

My doctor, nurse, and Mike started cheering and coaching like I was about to set a world record for, ah, something or other. GO GO GO GO GO GO YOU CAN DO IT YOU’VE GOT THIS YOU’RE SO STRONG GOGOGOGOGO!

“Okay,” my doctor said, “I’m going to have you stop because you’re having a baby.”

The nurse hit a button on the wall, called for some other folks, and soon enough I was contracting again, and pushing like a madwoman. Despite having just started moments before, pushing was still the most thoroughly exhausting and draining physical work I’d ever done. About thirty seconds into my first push, I was overwhelmed. “I can’t do it!” I screamed. “You already did,” my doctor replied. “The head is out!”

And just like that, Georgette Beatrice Guinn Anderson was born, at 5:45. She went straight in my lap, and the doctor offered Mike the scissors, then reconsidered and offered to let me cut the cord. I deferred to Mike, and then sweet Georgie went straight on my chest. She wriggled and spontaneously cried, and everyone marveled at how gigantic my nine-pounder was (everyone except Mike and me, who couldn’t believe how bitty she was compared to the ever-expanding toddler at home!).

She is utterly, totally Georgie, and we’re so happy to know her!

There’s a bit of a p.s. to this story, where I hemorrhaged and was scared, where Georgie spent her first night in the nursery, but where everything was ok and the hospital food was remarkably good and then I came home on Winnie’s birthday and baked her a strawberry-rhubarb cake.

I’ll probably write that story someday.

Georgie, A Birth Story: Early Labor

As the end of my pregnancy with Georgie approached, I felt tremendously confident in my ideas about all-caps BIRTH–the conceptual, pluralistic, nebulous ideas about the kinds of birth experiences that should be afforded to all women. Evidence-based, empowering, unjudged. Freedom to make decisions and access resources without a shred of fear-mongering of any stripe (Your doctor only wants to cut you open! Your home birth will end in certain death! I know we just met but I have lots of opinions about your VBAC!) A climate in which women are presented with heaps of unbiased information but still encouraged to go with their guts. You know, just like perfect birthing culture.

But I felt utterly, totally ambivalent about my own birth, absolutely pulled in competing, mutually exclusive directions. In the weeks leading up to Georgie’s birth, I waffled back-and-forth about the kind of birth I wanted to have, about what parts of the experience I placed a premium on, about what mattered to me and what I would choose should a choice present itself. Did I want to wait until 42 weeks to schedule an induction? What if I didn’t? Did that mean I was putting my own discomfort with the anxiety of waiting above my trust in my body? And what if I did want to schedule an induction before 42 weeks? Did that mean I was ignoring the teeny tiny smidgen of evidence that tied birth after 41 weeks to an increased risk of stillbirth, without evidence of an increase in improved outcomes? And why didn’t anyone in my seemingly empowerment-based practice of medical professionals seem interested in discussing any of this with me?

After much moaning and groaning, phone calls with everyone I know who would listen, reading and rereading and then reading again articles and opinions and anecdotes, I did call my practice to change the date of my induction from 42 weeks to 41 weeks and four days– just a world of difference, I know.

In the end, it didn’t matter because, unlike with Winnie, I went into spontaneous labor with Georgie. It was utterly thrilling. My ability to wait– which, if translated into a physical size, would be like the speck of dust on the head of a pin made for the world’s smallest doll–was tried with every moment that ticked by after my due date. I was having lots of uncomfortable, unproductive contractions, the kind that didn’t lead to any sort of meaningful change. I was dilated a couple of centimeters, my cervix was soft, and so everything I could do to get the proverbial show on the figurative road was already done. Short of employing an honest-to-God method of augmentation, the changes my body needed to make were made–I just wasn’t in labor. I stayed up late at night, into the early morning, ostensibly “meditating”, which was really just willing myself to go into labor. The night before I went into labor with Georgie I got out of bed after hours of tossing and turning, took a long shower and sipped the world’s ittiest bittiest sip of castor oil. It was something I had told myself I wouldn’t do, the bottle still in the house and sealed from when I purchased it after going postdate with Winnie. I braced myself for a night of gastrointestinal distress – but it never came.

I did, though, wake up in the morning with what I thought might have been contractions. I woke up around seven to some rhythmic cramping, but I didn’t want to jinx myself and so I went back to sleep, willing my eyes closed and my mind quiet. Mike very kindly occupied Winnie without my asking until around nine (legitimately luxurious sleep!), at which point I could no longer ignore the increasingly intense contractions. I started timing them and they were rolling in about every four minutes, lasting just about a minute. This was a few minutes closer together than the interval at which I had been advised to call my doctor, but my water hadn’t broken and the pain wasn’t unbearable so I let Mike know that I thought we were having a baby in the near future, and we started gathering the last few items on our list and pumping Winnie up for a day of fun with the exceptionally kind folks who had offered to care for her. The contractions grew stronger and closer together, and the midwife who returned my call and endured my moaning thought we should probably start heading toward the hospital.

I was ecstatic. I couldn’t believe I had gone into labor on my own, at just 40 weeks and 5 days. Somehow, despite the fact that we were “packed”, it took for-ev-er, or approximately one million lady-in-labor hours, to get the last bits gathered and get ourselves out the door. I finally lost it– after at least three entire minutes of patience– and decided I would walk Winnie the block and a half to our friends’ house to drop her off. By myself. In labor. I grabbed her bag and my keys and told Mike to come pick me up when he was done.

It was warm, grey, and gently drizzling outside. A few minutes before 10 on a Saturday morning, the neighborhood was coming to. Families headed to and from the playground with scooters and bikes in tow, a handful of folks sat and waited among the roses and clematis as the public library started unlocking its gates, community gardeners already hard at work in their plots, paper cups of coffee gripped in hands strolling up and down the block.

I stopped for a contraction outside of the house with all the gnomes, a helpful distraction for Winnie. We made it to our friends’ spot, at which point I panicked. I had left my phone at home. Their sweet dog, like so many dogs, hates the doorbell with the fiery passion of ten thousand suns. Making the dog bark might also make the baby cry. Which makes the adult humans have to address them both. Basically the ideal situation to create for our friends who were adding our kiddo to their workload and also for our kiddo to walk into on the day I’m all, BYEEEE SEE YOU IN A FEW DAYS! Walking back seemed like a million miles. Should I just scale the fence and throw rocks at the window? That most certainly wouldn’t disturb anyone. Suck it up and ring the bell, Guinn Anderson. So I did. The world didn’t end.

We clambered inside and I started giving totally unhelpful information about Winnie as another contraction started: “she eats…. FOOD. Please change…her…diaper. MOMMY IS FINE JUST FINE JUST LETTING MY MONKEY DO IT YOU KNOW.” Knowing Winnie was in good hands, I had to leave, get out and fast. I needed to move. I hustled back home, avoiding eye contact with every person I passed lest a contraction hit in the midst of a neighborly hello, contorting my face into that of the Hulk. A couple of contractions slowed me to a stop. I leaned and swayed and moaned, against a brick wall, a fence, an overgrown planter. I hauled up the stairs– to an empty apartment. Because I told Mike to come to me. And I didn’t have my phone.

I have long opined that having a library card is like being registered to vote- it opens an entire world of agency and empowerment, connects you to your community, and it’s terrifically free. We grow food at our library, pass our days at our library, check out books on books on books. Oh, and they have a phone. So I waddled through the front doors and up to the circulation desk. “Hi. I’m in labor and I need to call my husband. May I use your phone?” I called Mike, asked him to pick me up at the library, and briefly considered perusing the new acquisitions shelf. The librarian was over the moon about my labor, and called out her colleagues from the back office to wish me well. Mike swung up to the curb, our giant blue birthing ball taking up residence in the backseat. I hopped in, and we headed to the hospital.

Welcome, Georgie Bea!

On Saturday, June 6, 2015, at 5:45 pm, we welcomed Georgette Beatrice Guinn Anderson to our little family. Georgie was 9 lbs, 2 oz, and 21 inches long.   She was born with dark hair dotted with sweet little stork bites, fingernails that already needed a clipping, all wriggles and squeals.

 

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Georgie’s first hour at home

 

I was pregnant past my due date, just as I was with Winnie, and though I found waiting to be mentally excruciating (the uncertainty!) the extra moments with my oldest, first girl were pure gold.

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When mom is a million weeks pregnant, anything goes.

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I’m sorting through the bits and bobs of Georgie’s birth story now, but below are a few images from our first two days with Georgie.

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Those ears! That hair!

 

 

 

 

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Born with the hands of someone 100 times her age

 

 

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Headed home!

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Birth Story, Part III

Read the first part of our birth story here.

Read the second part of our birth story here.

And then I had a baby!

That’s what I felt like, anyway, after months and weeks and days and hours on hours of waiting.  I was fully dilated!  Here comes baby!  I mean, all I had to do was push her out.  That was it!  That’s all!  Just use some sort of some kind of muscle-y thing, some special combination of squinching up my face and calling upon my inner tiger/lion/bear, right?

I’ve admittedly avoided writing this segment of my birth story only because this last phase— the most painful, utterly exhausting, downright gross (and shortest!) phase of labor yet— was my absolute favorite.  I would go through that handful of hours over and over and over again just to have that single moment of hearing sweet Winifred’s voice for the first time.  I hope I can do those hours justice in the retelling.

I was ridiculously excited to labor, particularly in the weeks before my induction.  I viewed the labor process as an endurance feat, an excruciating, overwhelming, ultimately rewarding experience.  I was, and still am, wowed by all that your body can and will do to protect and deliver another human from safe and snug inside of you, into a bright, bustling world.

I always found it funny—and difficult to remember—that pushing was the second of three phases of labor.  Surely it had to be third or fourth or maybe twentieth, what with all the prodromal labor and early labor and active labor and transition phase and whatnot. But no- everything until now had been one, cohesive phase, despite its ups and downs and stops and starts.  It was only now that we moved into stage two.  Looking back, this makes so much sense.  Even though each moment between when I was ready to meet that darn baby already and when ol’ Doctor Fully’s eyes got wide seemed so singular, so distinct, once I reached full dilation all of the hours previous ran into one another and the task before me suddenly came into focus.

Enough with the hippy-dippy pontifications— I was about to push this baby out.  This is the point where I apologize to my family members and friends with more delicate constitutions because it’s about to get rather real up in here, with a whole lot of colorful language and some fairly frank discussion of bodily functions.  So if you’re the kind of person who’d rather skip all of that, here’s the short version: I pushed, it hurt, and I fell in love again with my dearest Winifred Eleanor.

But if you’re not squeamish, here’s how it actually happened:

There we were, at ten centimeters of dilation, fully effaced.  This babe, though, still wasn’t in any hurry to meet the world.  She was hanging back at a -3 station, meaning she hadn’t yet begun to descend into my pelvis.  This wasn’t particularly surprising, since she’d been ‘floating’ during all of my previous exams, not yet engaged in my pelvis at all, but it wasn’t exactly great news, as it meant she had a bit of a trek ahead of her.  The actual great news was that Winifred had corkscrewed herself from the occiput posterior/face up position (which causes back labor and puts the skull in a less desirable position for descent) to occiput anterior/face down— the perfect position for descent.

In all my hippy woo-woo books about natural birth there were about a thousand warnings about how my doctor was going to want to give me a routine episiotomy for kicks, give me an emergency c-section so that he (she, in this case) could go play golf, force me to lay on my back, and generally ignore all of my preferences in favor of the opposite kind of birth that I’d hope for, all with the BUT DON’T YOU WANT A HEALTHY BABY line hanging over my head.  Nope.  Not my doctors, not a single one of them in a practice of seven.  I knew that in my gut before I went in, but of course I hadn’t been able to get a single doctor to say, “Sure, Sascha.  No-way no-how are we going to give you a c-section even if the most wild, crazy, dangerous thing happens to you or your baby!”  They would say, though, that their wish was for me to have a vaginal birth, and that they were going to advise every single thing in their power to make that happen— and, as I’ve stated before, that my voice would be a part of all decisions.  At this point, I had been in labor for 18 hours, in their care for 21, and not once had anyone made me feel like I was rushed— when they broke my water (yes!  AROM! in my hypnobirth!), they told me there was no 24-hr clock to race against; when I had only dilated a centimeter after twelve hours, at the max dose of Pitocin, they told me to get some rest and that they would check back in the morning.  Literally the only time anyone mentioned a c-section to me was well before I was induced, at one of my last OB appointments when my doctor said, “Hey, by the way— there’s this thing called shoulder dystocia, and it’s wild.  If we think it’s happening to you, someone’s going to mention the possibility of a c-section and I’d prefer if the first time you heard those words wasn’t in the heat of the moment.”  And that was that.

So, with all that said— here I am, babe waaaaaaaaaaaay high up in her little cocoon, with a fully dilated cervix.  I was giddy, high on adrenalin, and finally ready to DO SOMETHING.  When the doctor came back in, she had me do a test push while she conducted an internal exam, and I eagerly awaited her instructions.  ”So— what do I need to DO?” I asked, quite possibily squealing, probably panting, with my eyes likely twice their normal size. “Just go ahead and hang out.  Sit up, and kind of bear down a little if you feel a contraction.  You don’t have to push— just tense your abs and hang out.” Wait, what?  My assignment is to sit?  To chill?  To wait?  And no one is freaking out about that except me?

It turns out this was awesome, effective medicine— the practice of laboring down or passive fetal descent shortens pushing time, reduces fatigue, and results in fewer decelerations.  And passive fetal descent, for me, was just… hanging out.

I thought for a few minutes that maybe they had forgotten about me— or worse, given up.  But every so often a doctor would come in, ask me how I was, and then just leave.  No fiddling with the Pitocin, no internal exam. Just a quick check-in and then back out.  My epidural was turned off once I was fully dilated, and I was feeling plenty, but I couldn’t have cared less.  Bring on the baby!

Hours passed, and finally Dr. M, who had been with me throughout my 20+ hours of labor thus far, was headed home.  Dr. R. was taking over, and I was pumped.  Dr. R had been my GYN prior to my first pregnancy (when I switched docs because she was on vacation and I had those first weeks jitters).  She was brazen, dry, hilarious, and a total badass.  The perfect push coach.

It had been nearly four hours since my last exam, so she checked me again to determine any change in station.  Sure enough, Winnie had wiggled down to a zero station, with her head in the middle of my pelvis.  Eager to get this show on the road and meet my baby already, I asked again, “So, can I do anything to help from a zero to a +3?”  I expected her to suggest the birth ball or changing positions in bed or some sort of pelvic rocking.  ”Yeah,” she responded. “Push.”

Oh.  That.

Look, I knew this stage was coming and I was crazy, over the moon excited for it.  But I hadn’t the slightest idea what it meant to push.  Sure, yeah, push— just, what is that again?  The thing where I squish up my face and scream a lot?

I must have watched a couple dozen birth videos, the last dozen or so just of the pushing stage, to get myself ready for this.  I had learned a few things about myself, like that I will cry like an actual baby during any and all birth videos, but I hadn’t actually learned HOW to push.  What muscles are those?  And are you sure I have them?

So she coached me, and I practice pushed, and felt like I was expending a lot of energy and accomplishing exactly nothing.  I wasn’t quite ready to begin in earnest, so she gave me a minute to hang out and wait for a stronger urge to actually push.

As soon as Dr. R left the room, it hit me.  It had been over a day since I’d had anything to eat, but I knew that feeling.  I needed to take the biggest poop of my life.

I knew going into this, of course, that the urge to push might feel like the urge to have a bowel movement— that stuff is all quite close down there, especially with quarters being so cramped those last nine months.  But I was certain that this wasn’t the same.  No, even though every sign pointed to TIME TO PUSH, I was reading all of those signs as TIME TO POOP. NOW.

I told four doctors of this need, convinced someone just needed to get me to the bathroom, bring me a bedpan, just SOMETHING YOU GUYS I AM TELLING YOU I WILL PUSH AFTER YOU LET ME POOP.  Dr. R came back in the room, and I explained my predicament to her.  She nodded calmy, and said, “Okay.”  Finally.  Someone who listened. “Then poop,” she finished.

Even to begin with, I’m not an overly modest person.  I knew I was going to lose whatever modesty I did have as soon as I went into labor, and I certainly didn’t have any qualms about leaving the door of my absolutely sweltering room open during my roughest contractions in order to catch a breeze.  But even I— she who will write the word poop several times on her family blog— wasn’t about to just, you know, right in front of two doctors, my husband, a nurse, and my kind doula.

But of course, I didn’t need to— I needed to push out my baby, the sensation of which just so happened to correspond quite closely with the most intimate of bodily functions.  And finally, that clicked in my brain.  I asked for the squat bar (which, by the way, despite being CERTAIN that I wanted to push squatting, I forgot to even ask to have them bring over to the bed, because squatting was the last thing I wanted to do once I started pushing.)

I pushed.  I pushed, and I pushed, and I groaned, and I used every fiber in my body to do something that I wasn’t sure was working but oh boy, was it ever taking it right out of me.  The uncomfortably warm room had leapt right on into unbearably hot territory, so I ended up shoving giant bags of ice under my arms and on top of my head to keep cool.  I was running a slight fever, but Dr. R wasn’t concerned, since Winnie’s heartrate was stellar, and it was about a thousand degrees in the room.  I pushed with each contraction for a count of ten, with the whole team cheering me on, and then crashed out for 30 seconds of sleep before gearing up to do it all over again.

I must have pushed for the better part of an hour thinking nothing was happening, that all of my effort was futile.  I threw myself back from my sitting position and declared that I was doing NOTHING and that if this kept on, I wouldn’t be able to do it anymore.  So there.  Looking back, there’s no way I would have possibly abandoned pushing, but there is something about an exhaustion so deep, so consuming, that pushes you to say those things as a matter of protection— all I need to do is say this, and then I’ll feel better, and I won’t actually have to quit.

Dr. R knew this, of course (see mention above of badassery), and she looked at me with a glint in her eye and practically guffawed. “I absolutely love it when women say that,” she said, “because it means they’re almost there.  Now get angry and meet your baby.”

And I did.  I pushed every bit of me that had every existed, every good and bad decision, every feeling, every thing I had ever done or left undone.  I used the time between contractions to scream at the room, “It is absolute crap that only women have to go through this.”  And then it got a little essentialist and gender normative in there for a minute, but hey— it worked for me, and my doctor called me a goddess, which doesn’t happen every day.  At least not to me.

Before I knew it, everything was on fire, and I pushed through that fire and the most amazing thing happened.  The room changed, and everyone seemed on the verge of tears and euphoria, and I reached down and felt my baby’s sweet, soft, squishy head of hair, and like that— one push, two pushes— she was here.

She screamed a hearty scream and within seconds she was on my chest, in my arms, snuggled right in, and we were a family.

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Within the half hour, she nursed, we cried, and all of us were ready for a nap.  We waited for my blood pressure to come back up to normal (I maybe tried to leap from the bed a little too soon and maybe almost passed out a couple of times), I got a good look at that impressive placenta Winnie had gotten so friendly with over the last few months (Seriously, excellent work, placenta.  Hope you don’t mind that we told Winnie we sent you to a farm upstate when we actually tossed you out like yesterday’s news.  Nice knowing you!) and we headed upstairs to recovery.

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It was the best day of my life.

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Birth Story, Part II

Read the first part of our birth story here.

Ah, the rain on the window, the gentle sunlight streaming in, the view of our favorite New York building fading in and out between the clouds— and a couple of monitors that no one could seem to get to work.  The gorgeous view was not meant to be, and I moved down the hall to a room with windows that opened to a wall— and not, like, a wall that was a foot away, thus letting in some light.  The windows were a good centimeter away from the wall, a wonder of institutional architecture.

I remembered a line from my favorite birthing book, The Big Book of Birth by Erica Lyon: “If you still care about the wallpaper in your birth room when you get there, you are there too early.” Sure, I was going to be induced so there wasn’t a technical ‘too early’, but the sentiment was the same; very soon, there was going to come a time— the important time— when I couldn’t care less about the quality of light in the room or the Chrysler or any other building.

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I chose not to write a formal birth plan, as I had discussed all of my preferences and options with all of the doctors in the practice (who would be the attending physicians during my labor) and I wanted to discuss face-to-face those same topics with all of the providers I hadn’t met (the nurses and residents with whom I would be spending most of my time).  I worried that a written birth plan would become a shallow substitute for real conversation throughout my labor, and I wanted to be forced to have those conversations,  to confront them in real time.  And despite all the books and articles I’d read, classes I’d taken, and questions I’d asked of each and every person who might have any insight whatsoever into the birthing process, I knew that I had no earthly idea what I was in for.  Best to play it by ear, stay flexible, and know that Mike and I could make informed decisions at any stage in the game.

That said, I’d be lying if I said I didn’t have any preferences going into the process, and I’d be lying even more if I didn’t admit that already, barely into the process, I was watching so many of those preferences fade in the rearview mirror.  I had chosen a Pitocin induction, and I had solid reasons for doing so (and I truly believed that it offered me the best route to an uncomplicated vaginal delivery), but that induction meant scratching off a number of items from my ‘Dream Birth’ list.  Intermittent fetal monitoring rather than continuous?  Because fetal distress is more common with pitocin, continuous fetal monitoring is standard.  Skipping an IV? The pitocin wasn’t going to magic itself into me.  Laboring at home until the last possible minute?  Clearly, that ship had sailed.

But knowing these things were off the table forced me to dig deeper to understand why I had checked those boilerplate natural childbirth boxes in the first place.  I didn’t want continuous monitoring or an IV not because I was afraid of them, or because I didn’t trust my providers to make judicious decisions regarding any information the monitors provided— I favored those options so that I could MOVE.  I didn’t want to be tied to a bed, on my back, in a way that prevented me from coping with the pain using my own body.  Even though my mobility was more limited— I couldn’t go walking the halls— it wasn’t eliminated, by any means.   Once the Pitocin kicked in and my contractions began in earnest, I was moving: on my birth ball bouncing or doing hip circles, pacing the room, on my hands and knees on the bed, and hanging onto Mike’s neck for dear life.

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Mike and Jillian, our amazing doula, were right next to me through each contraction— grabbing smaller birth balls that I could squeeze during particularly strong contractions, doing Rebozo sifting to relieve some of the back labor from my stubbornly OP babe, and gently reminding me of the breathing and relaxation techniques I had been practicing for the last few months.  Sure, some of the visualizations and relaxation exercises I had planned to use flew out the window as soon as I knew that the whole oxytocin-positive-feedback-loop I’d been banking on wasn’t going to happen, but our practice of Hypnobirthing and Mindful Birthing techniques was incredibly valuable, as were the breathing exercises I’d worked on from The Healing Power of the Breath.

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But as midnight drew near, I was running out of steam.  I swear I’m not involved in some sort of hilarious bet to see how many times I can say the word Pitocin— but, y’all, that stuff is a game changer.  I’d heard and read that Pitocin-induced contractions were wildly different than those experienced during spontaneous labor, and I was quickly finding out how true that was.  My contractions were coming fast and strong, with almost no rest between them.  I thought I surely had to be in transition, because I had hit a wall.  I was exhausted and in pain that— in addition to being the worst of my life— did not quit.  I couldn’t catch my breath between contractions, and the techniques that had worked so well earlier in my labor were ringing hollow.  I tried every position, every breath, every visualization I could, and while they got me through those contractions, I was left with little time and even fewer emotional resources to help me recharge before the next excruciating pain hit.

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I told Jillian and Mike that I only wanted to talk about pain relief between contractions, when my head was clear and I wasn’t being swayed by what I felt in that moment.  And when I stopped being able to differentiate when that time was, I knew that I needed to explore my pain management options.  Again I was forced to dig deeper and ask myself why I wanted to avoid an epidural: I was afraid of a loss of mobility, I was afraid of a loss of control, and I was afraid that I wouldn’t be able to push my baby out.  But I couldn’t be mobile in the pain I was in— it was all I could do to start to change positions after the end of a contraction before the next one hit.  More than once I was caught with one leg off the bed and one leg on or just out of reach of the ball I’d been lunging for when I was consumed with pain.  The pain was impacting my mobility, rather than the other way around.  And if this kept up, there was no way I would have the energy to push; I was already falling into a nightmare-like state of exhaustion in the seconds between contractions.  After several fifteen second chunks of conversation with Jillian and Michael— and after more than a few ‘Let’s just try one more contraction’— I knew that either I had to be getting close to the end, or I needed more relief than I was able to give myself.

Jillian found the attending physician, and I asked her to perform a cervical check to see how far along I was before I decided to have an epidural.  I had come in two and half centimeters dilated, so after twelve hours of labor, I expected to be at least six centimeters.  If this was the last stage of active labor, and I was close to full dilation, maybe I could power through.  She checked, and I waited with bated breath.

I WAS THREE AND A HALF ARE YOU KIDDING ME.  One centimeter’s progress in TWELVE HOURS.  I swore profusely, so profusely and so skillfully, in fact, that one of the doctors had to retreat to the corner to get her laughter under control.  Please, someone, find my new best friend the anesthesiologist AND FAST.

I got the epidural— during which I was certain I was going to render myself permanently incapacitated by wildly flailing during a contraction, which you’ll be glad to know I avoided (as an aside— what kind of horrible joke is it that you have to endure horrendous contractions and hold perfectly still while you’re having the medicine administered that you need to get those thrash-inducing pain-nadoes under control?).  I had two more killer contractions, and then magic happened.  Blissfully, I started to feel only pressure.  I could still move my legs, still sit up, still feel that a contraction was happening— but now I could talk, I could focus on the fact that BABY was near, and WONDER OF ALL WONDERS: I could sleep.  I slept on and off for the next six hours.  Six delightful hours of rest, interspersed with conversations not laden with expletives about things other than crippling pain.

After six hours, at which point I might have appreciated the beautiful sun currently rising above the skyline in my previous room (HEY GUESS WHAT I CARE ABOUT THE WALLPAPER AGAIN), I started feeling some discomfort that required those same pain management techniques from earlier.  As the pain in my tailbone grew stronger, I asked a doctor if we should think about turning up that epidural.  Yes, I drank the epidural koolaid, and I would have drunk the epidural straight from the bag if they’d let me, too.

As she checked my dilation, her eyes grew wide.  ”No way,” she muttered.  ”NO WAY.  Oh my god oh my god NO WAY.”  All kinds of situations ran through my head. If my three and a half centimeters of dilation, my blood sweat and tears three and a half centimeters that I had been working on for WEEKS had disappeared, I was definitely going to take off an appendage from someone, and soon.  ”You’re fully,” she said, because as I learned, nobody says fully dilated, maybe because they’re too used to people shrieking with joy once they get to “You’re f-“.   I surely did.

Just to recap, for those of you keeping score:  twelve hours of painful, intense, oh-god-kill-me-now-in-a-metaphorical-sense-of-course-but-actually-that-last-contraction-made-me-reconsider-my-qualification-of-metaphorical contractions? One cm dilation.  Six hours of blissful rest, including some solid honest-to-goodness sleep? ALL OF THE OTHER CENTIMETERS.  Which is six and a half, and that’s a lot of damned centimeters.

Perfect.  Now all I had to do was get this baby out.